Healthcare Provider Details

I. General information

NPI: 1962519678
Provider Name (Legal Business Name): ROBERT F CHIRLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 05/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 LOW ST
NEWBURYPORT MA
01950-3556
US

IV. Provider business mailing address

257 LOW ST
NEWBURYPORT MA
01950-3556
US

V. Phone/Fax

Practice location:
  • Phone: 978-465-7121
  • Fax: 978-462-5304
Mailing address:
  • Phone: 978-465-7121
  • Fax: 978-462-5304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number55212
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: